Havering Education Psychology Service is part of the London Borough of Havering's Education Services. Working with families and in school settings, the Psychology Service helps children and young people up to the age of 19.
This case study focuses on a community-based project team within the Service: the Thinking, Learning and Caring (TLC) Education Psychology Service Sure Start Project. The project team comprises six people, including educational psychologists, family workers and a specialist teacher.
All members of the team are mobile workers and usually spend up to 40% of their time working alone. They make home visits to families within the local community. They visit drop-in centres. They attend support groups such as Sure Start Centre, playgroups, nurseries and schools. They also work with colleagues from other agencies such as those involved in training, consultation and workshops.
When team members visit a client's home, they often carry out assessments, make observations and conduct interviews. Following the assessment, they devise programmes to help make a difference to the child. Most programmes deal with behavioural problems and social communication.
- Drugs and alcohol use by parents or carers: this can sometimes cause people to behave in an unpredictable or irrational way.
- Mental health problems of parents or carers: sometimes people with mental health problems may present a risk of violence, but this is uncommon.
- Resentment of family: there is the risk that the client's family may resent the presence of the team member or their help, although this is rare.
Examples of incidents
- Possession of a knife: on a home visit, a client answered the door holding a large knife. The client had apparently mistaken who was at the door and did not intend to hurt the staff member.
- Inappropriate dress: on a home visit, the client's father was in a state of undress. The team member suggested that it may be more appropriate for her to work in a different room and explained to another family member that the father's state of undress was not appropriate. The issue was eventually resolved, but the member of staff felt uncomfortable at the time.
In general, the lone working arrangements have been set up by the team members themselves and are fairly informal. The focus is on preventing violence. Communication between staff about violence issues is a key part of the programme.
Training and information
Supervision: Staff receive a high level of supervision so they can immediately raise issues or concerns about violence. If a team member feels uncomfortable during a particular visit, this is discussed in the regular supervision sessions. This is taken very seriously; all subsequent visits to that particular client are made with another team member.
Communication skills: good communication with clients is an essential part of team work. There is a strong focus on communication, conflict management, mediation and avoidance skills. The basic philosophy is that most problems can be resolved over time if the quality of communication is good. The ability to communicate effectively is a key element of the selection criteria for appointment to the Sure Start team.
Key communication skills:
- The ability to listen.
- The ability to pick up on non-verbal signs of distress, inattention or anger which the client might be feeling.
- A high level of self-awareness of one's verbal and non-verbal communication and its effects. This requires a high level of self-awareness.
- Ensuring that clients have the opportunity to express their thoughts and feelings.
These skills are best developed through regular self-checking by the team member and appropriate supervision. Development of staff skills is evaluated through the staff appraisal system.
Other training and support: induction training, role-modelling and a programme of continuous staff development and support helps to develop the skills needed.
Background information on the client: the team receives requests for its services from other professionals as well as from clients themselves. Although it is not stated specifically on a request form, there is an understanding that the team needs to know of any reasons why its members should not visit a client at home. Conversations with other professionals also help to highlight any violence risks. Team members' local knowledge of the community also means they often know the background of the families they are working with.
Mobile phones are provided to all team members. Staff call a designated team member to confirm that a visit has ended. If no call is received, it is the designated team member's responsibility to contact and locate the member of staff.
Joint visits: when a first visit is made to an unknown client, two staff always attend. This is a particularly successful measure.
Diary system: all team members have access to an accurate timetable of visits kept in the diary.
Withdrawal of service: this is an option if the behaviour of a client is unacceptable and intentional.
Change of personnel: if a member of staff experiences verbal abuse, this suggests a breakdown in the client/staff relationship. Immediate action follows, for example a change of team member.
Less successful measures
Visits in local community settings
Thought was given to visiting clients in local community settings such as clinics and schools if lone working was not appropriate. However, the ethos of Sure Start is to see families in natural settings where clients are more likely to be relaxed and open. This can also help to minimise potentially violent incidents.
Benefits and costs of measures
Positive attitudes and feelings: staff have expressed positive feelings. For example, they know that their health and safety is being considered while out on lone visits.
Staff morale: morale increases when staff feel they are being listened to. Because of the high level of supervision that staff receive, there is constant feedback about feelings and morale.
Positive image: these benefits to staff combine to give a positive image and perception of the team. Team members have expressed this opinion.
Minimal but relevant costs: some of the measures have incurred costs, such as the adoption of mobile phones and joint working.
Valued supervision: supervision can be time-consuming and costly but is seen as essential for health and safety reasons and also for effective working and professional development.